Caesarean vs vaginal birth
Today, Caesarean or C-section births are increasing. One reason is the growing number of women for whom they are medically necessary. They include women in their late 30s and 40s who are having babies, and it is understood older women generally make poorer candidates for vaginal birth.
On average, older women sometimes gain more weight, have bigger babies, and suffer higher rates of complication, such as high blood pressure and gestational diabetes. Each of these factors can make caesarean birth necessary.
Older women are also more likely to undergo infertility treatment, which is associated with a higher rate of caesareans. Doctors may be more willing to operate because it allows them to control the baby’s birth, an important factor since it may be the woman’s only chance at motherhood. Infertility treatment also can result in multiple pregnancies, a well-known risk factor for C-section.
Still, medical professionals tend to frown on the surgical procedure as invasive and risky, at least when compared with a vaginal birth. That’s why planned C-sections are officially allowed only in certain cases, such as when the foetus is in the breech position, when the mother has had a prior caesarean, or when she has a gynaecological condition, the cervix not being well dilated at the time of delivery.
Caesarean vs vaginal delivery
It may not be fair to compare the success of an emergency C-section done when both mother and child are in distress with an uncomplicated vaginal birth. But even if a C-section is planned, there’s no debating that the surgery carries more personal risks than a vaginal birth.
So why would a woman want a C-section if she doesn’t really need one? For starters, proponents of choice say vaginal birth is not risk-free, especially for the infant. Though extremely rare, skull fractures, paralysed limbs, and brain damage can occur when a baby gets stuck on its way through the birth canal and must be extracted with forceps or a vacuum device. Unfortunately, these events can rarely be predicted.
Loss of sexual sensation is another common complaint among women, who have given birth vaginally, said Dr Frederic Frigoletto, chief of Obstetrics at Massachusetts General Hospital in Boston, USA.
“The risk of this may increase if the mother is given an episiotomy — an incision in the tissue between the vagina and the perineum that widens the vaginal opening. In fact, data from the University of Ottawa shows that women who have episiotomies experience the lowest levels of sexual satisfaction up to three months after giving birth, compared with those who don’t get them,” explained Dr Frigoletto.
“The site of the episiotomy can develop scar tissue that may interfere with sensory perception — just like incisions anywhere on the body,” he added.
Episiotomies are performed in nearly half of all vaginal births, triggering pain, the chance of infection, and occasionally permanent problems, such as fecal incontinence. Studies show that women are more likely to suffer such consequences if they have an episiotomy than if they tear spontaneously during delivery. Episiotomy wounds tend to be more severe than tears; therefore, many doctors and midwives promote the idea of letting women tear naturally. This is one procedure, which the patient may choose after discussing the matter with her obstetrician.
